Adhd, Medication, Training

Hello coaches! Starting off, 5 stars, listen to you guys every chance I get. Always telling people I meet to tune in. Keep it up! (first time poster on here though sorry for any mistake I make)

Going to try and keep this short, but to get to my questions with enough information on me, I have to give a brief history so bare with me.

I’m 31, 5’10", 178 lbs currently (normally in the summer 170) I have severe ADHD, so I’m taking amphetamine salts, it’s a pure amphetamine unlike some combos that people get prescribed. I just started riding a bike at 29, prior to that I hadn’t been on a bicycle since I was 13 or 14. I rode 2 or 3 times with my fiance and decided I wanted a bike. 2 months later (Christmas 2017) I got an old steel bike. Did my first 40+ mile ride shortly after and decided I wanted more. My fiance then said she wanted to do Petal Pedal, a 100 mile supported century in Silverton Oregon. So I said yeah, let’s do it. I was told that 3 months was joy enough time to be ready since I had never ridden bikes really before.

It was this moment. The moment of being told I couldn’t achieve it, that got me so pumped. I dove headlong into riding, and soon bought a older used Specialized transition comp, rode Petal Pedal in just under 6 hours. My fiance then set her sights on Seattle to Portland. So of course I decided I had to do it too. From never riding a rode bike, to Seattle to Portland (2 day) success I had only been on a bike for 7 months. Then I burnt out. I was tired. And wanted weekends to spend with my fiance and not always on the bike. So I kinda stopped riding so much… Miles tapered and training slowed. Then 2019 hits and riding has to be back burner. I get married this past summer, I got a decent amount of riding but 2019 end with 2000 miles. 2020 I am doing STP one day, goal of sub 12 hours. My training plan has me at just over 3500 miles by STP date mid July.

Thank you for bearing with me through that. For any references needed, strava.com/athletes/24485130. So my questions:

  1. when climbing hills, or sprinting all out my heart rate normally is around 200 with me blacking out with tunnel vision at like 205. I love climbing and have done a ton of it, I normally am not concerned about it but with the increase of training am I going to actually kill myself while riding?

  2. for I feel like my short cycling experience has seen lots of growth, am I setting myself up for failure or injury by continuing to want more and more lofty goals without the long history of riding?

  3. is there any research showing people with Adhd, that are medicated, being stronger or more adaptive riders?

  4. while riding STP solo, I can draft confidently, butis it a bad idea or against ‘the proper rules’ to dive into a group. I don’t mind pulling twice as often, I just don’t want to be ‘that guy’.

Thanks for anyone who actually made it this far, hope everyone is off to a great new year. I’m happy to fill in or answer any questions or clarifying information with this post.

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:wave: fellow ADHD person here, with hopefully a bit of guidance.

Probably not. There is very limited evidence to support the theory that ADHD medications cause any sort of cardiac episodes. That being said, your doctor should be screening for high blood pressure and other heart disease as a part of your normal checkups, so as long as nothing comes up abnormal, you should be good to go. Personally I’ve noticed a bit of difference between the different medication types and how they affect heart rate, so just pay attention to your RPE and your data and if something feels “off”, then it’s worth making a note of.

Unrelated to the ADHD, you are probably better off climbing at a more sustainable pace rather than all out all the time :wink:

Not directly. No reason to limit yourself on what you can achieve, as long as you aren’t investing your personal self worth in the outcome. That being said, make sure you keep an eye on burn out, rest, and your general mood. Being mindful of these will help you enjoy this sport for a long time to come.

Generally no, but it’s complicated. The most clear piece of research I’ve found has to do with the difference between regular and warm temperatures as it relates to time trial performance, where medicated participants had higher power outputs and higher core temperatures in the 30C trial compared to control. There was no difference between the medicated and control groups in the 18C trial.

As such, most stimulant medication is banned “in competition” but not “out of competition”. You can apply for a TUE if you plan to race in sanctioned competition, but will need a lot of documentation and two separate diagnosis from different psychaitrists . Fortunately, ADHD doesn’t require a “failed trial” with a non-banned medication, since the non-banned medications are not considered good therapeutic options anyway.

ADHD folks tend to “hyperfocus” which tends to be a benefit to training regardless of whether they are medicated or not.

STP is a “ride” not a “race”, so observe all common etiquette when encountering other groups. If you’d like to draft off anyone, it’s generally a good idea to ask the other folks if you can “rotate through” with the group. As long as you are a courteous, smooth, and safe rider, most groups will be happy to have someone take a pull. Just make sure you aren’t inadvertently riding people off your wheel, blowing up the group cohesion, etc.

Hope this is helpful and good luck :+1:

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I am actually really interested in this thread.
I also have ADHD, but since I do my workouts first thing in the morning, and take my medication after, I’ve never experienced anything I would consider a side effect from the medication.

I too was prescribed amphetamine salts and that’s what works best for me.
I take them throughout the week and give myself a “med break” during the weekends.

If anything this thread has brought to my attention this is probably something I should discuss with my doctor. I never thought to discuss it with him before, so thank you for that.

These days, I generally take the meds with breakfast and roll out the door immediately after, so between absorption rates and the extended release version I’m on, I don’t get a lot of issues either these days.

Previously though on a different medication, I had serious elevated heart rate to the point where I stopped the medication in favor of riding, since I was getting more of a therapeutic benefit from the bike at that point.

Agreed, I take one day off on the weekends.

I was just looking at this…new for 2020. I don’t see Adderall listed as a banned substance. Am I missing something?

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The global spelling is different for some reason (Amfetamine) and is on that list.

Basically all stimulants are banned “in competition” but fine “out of competition”. If it shows up in your system during a competition and you don’t have a TUE it’s a violation.

The washout period is something like 5-10 days.

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So, to get in a few answers or replies to you guys, @stevemz I have been monitoring my blood pressure and kept updated training info or heart rate information being brought up with my DR when I visit bi-monthly. The climbing pace is fine, its just when I do a couple of the local “monsters”. 25-27% for 1 mile. They basically crush you, that is when I see those SUPER high heart rates or when I am really far into a long ride day and I then try and sprint at all out efforts.

About core temperatures, my wife calls me a “furnace”, I have always run 1 to 1.5 degrees hotter for core temp. I have done 0 “sanctioned” competition rides, and have well documented need of the medication by numerous DRs, due to being involved in case studies and evaluations.

Thank you all for your replies! I am intrigued to hear how other peoples growth or cycling experience has been if they are medicated and if they feel the same way.

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Just a minor addition to all of the great, thoughtful replies: I have moderate to severe ADHD (on the Brown’s Scale, which sets a cutoff value of 45 for “at this point you definitely have ADD”) I scored an 89 – one of my coworkers called me “Double ADHD”.

That being said, I had to pretty much stop taking stimulants (Adderall, for me) on a regular basis. I used to have 20mg of extended release Adderall in the morning, and 10mg of standard release in the afternoon, and it wrecked my legs – they would be weak, almost numb, and I was noticeably impaired. Apparently, one of the ways that stims work is by shunting bloodflow to the brain, and it does this by constricting bloodflow in large muscle groups. My doctors said “yeah, this is the price you have to pay”.

Since then, as I’ve gotten more “serious” about cycling, I’ve had to limit my use of stimulants to 2.5 to 5 mg of Adderall in the morning, and that’s it. My performance at work has, unfortunately, been less laser-like focus (I once held a very successful, very technical meeting while wandering around the parking lot during a fire drill) but I’ve had to deal with it.

I’m sure there will be periods where my use of stims will trend up or down, but I know that, personally, there is an inverse relationship between my usage of them and my performance on the bike. Naturally, your own personal experience may vary.

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I had a similar experience with Adderall and stopped taking it for the same reason and in fact was off medication for a long time because I didn’t like the side effects. I would talk to your doctor about other options since there are a bunch of other options that you might respond to differently. I was able to find a medication that works well for me, avoids the negative side effects that I had on other drugs, and doesn’t impact my cycling performance negatively (or positively for that matter, since I really just want to be “normal”)

The other thing to be aware of is that unfortunately the “generics” situation for medications is pretty complicated and you’ll want to double check the manufacturers. There are a few manufacturers where the generic version is not considered therapeutically equivalent and functions differently, even though it gets dispensed as the same drug. I ran into this recently and couldn’t figure out why I felt so different until I did some digging in :frowning:

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Although I am a physician, this is NOT medical advise. Consult your doctor for proper medical advise.
On one hand, ADHD medication at low to therapeutic dosages is the equivalent of about 20+ cups of coffee. Therefore, taking your amphetamines potentially improves performance. On the other hand, it increases sympathetic tone, causing increase in Heart Rate, as well as an increase Blood Pressure/Afterload/Pressure Resistance the heart has to overcome to pump blood out, which makes your heart work harder to pump out the same amount of blood compared to lower BP. That can make you more susceptible to heart attacks or strokes. It could potentially be contributing to increasing your heart rate to that “tunnel vision” zone you talked about. Make sure your psychiatrist, cardiologist, and general practitioner evaluate all the relevant medical information and assist you on setting safeguards to minimize any negative adverse effects of treatment in your training.
In addition, it is common for people with ADHD to over-focus on things they are interested on. Therefore, ADHD could make you more focused on your training, as long as it continues to be naturally engaging to you. Otherwise, you would be more likely to drop biking/training altogether.
There are many other factors related to ADHD and performance. In general, proper management of your ADHD should be beneficial to your performance on the bike, as well as off the bike.

Don’t forget: you are not ADHD; you are a person who happens to have ADHD. Just like everyone else is also partially healthy and partially sick. Like the most authoritative text in Pathology states on its first page: “The perfect health is like the perfect disease; they don’t exist.” Everyone is simultaneously sick and healthy. That relative balance is what makes us susceptible to illness/injury/death. Regardless of what body system is afflicted, brain as is the case in ADHD, or heart, or anything else.

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Hrmmm. Interesting. I was under the impression that you had dexadrine, methamphetamine, and methamphetamine salts, and that was it. Dex was no bueno for me – it was an aggressive, over-caffeinated high and the downsides outweighed any benefits, for me. Pure meth (prescription form, of course) was okay, but meth salts were where it was at, for me. I’ve never had a name-brand version of any of them, but I’m not expecting that to be some magic wand.

If anything, I would want a stim that was fast-acting with a short-half life – take it in the morning, get a good, productive 4 or 5 hours in, and coast through the afternoon without turning my legs into stilts. This rules out the extended release versions of any stim, so I’m not sure what’s left for me.

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@jpolchlopek I think you will want to investigate the actual name of what you were taking, from a fairly well versed person on ADHD and its related medications (at least I think so)… there is no Methamphetamine that is prescribed. Methamphetamines are the dirty drugs people are cooking up in trailers and cause scabs and tweakers to go crazy. Now Amphetamines are what the pharmaceutical industry makes, and what DRs prescribe.

@Omar_Ayala I understand your not giving advice. I guess for me, I have been part of case studies, and extended studies for high dosages over long periods of time. 60+mgs daily… Currently to function I am on 25mg extended and 15mg fast acting at noon, combining adderall and escitalopram it is the perfect combo for my brain chemistry. Been working with a multi DR team to get it all dialed over the course of about 20 years. I guess I just dont know how in get their data to work with a sports medicine person who could do some testing on VO2 max or heart-rate stuff, like at my local major hospital (OHSU)

Methamphetamine is prescribed under the name Desoxyn https://www.rxlist.com/desoxyn-drug.htm

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I have never heard of Adderall having a negative effect on endurance/athletic performance… it there an article you can link to?

My GP and my psychiatrist both know I am a competitive cyclist and have never mentioned side affects associated with it…

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This is a decent overview to start with: https://www.physio-pedia.com/The_influence_of_ADHD_medication_on_physiologic_processes_and_exercise

TLDR it’s pretty varied and fairly individual on both the positive and negative end.

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Thanks I had no idea about Desoxyn. Is it fairly uncommon?

Thanks, man.

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I wouldn’t rule out the extended versions, since they have very different activation profiles and you might tolerate them better. There are also some other benefits to having more coverage, since ADHD folks have a laundry list of other comorbid issues (like missing social cues and being accident prone) that I only recently became aware of as an adult. No one told me when I was originally diagnosed at the end of high school that it affects things beyond school work :man_shrugging:

Vyvanse is a newer brand name drug that is supposed to be well tolerated because it’s a “prodrug that is therapeutically inactive until metabolized in the body”. Essentially it doesn’t turn active until the liver strips off some parts.

@stevemz Vyvanse was a total train wreck for me. I have always believed that ADHD medications only had to work “acceptably” for 20%+ of the patients for it to become recommended. I worked with a group of psychologists and psychiatrists from age 8-24, running a myriad of medications and treatments. All the while doing every sport I could get my hands on; junior bull riding, football/basketball/lacrosse/soccer, rock climbing, mountaineering, and then I found skateboarding. Skating allowed me a way to get through all my social struggles and find a group of similarly interested people. After 14 years of that, traveling the US, sponsorships, surgeries, and lots of hospital bills, I could no longer ride, and that reality was crushing. I found cycling after 4 years of nothing, no sports or activities, and immediately found the same intensity and passion I knew from skating, reborn into my newfound love for cycling.

The reason I explain all of that is the entire time I was doing any treatment, diagnoses, or working through things, I had my physical outlet. From what I have heard or read, all of us ADHD folks need that outlet immensely. The people I have seen that let their symptoms of ADHD run roughshod over their lives normally dont have an outlet, or are being miss prescribed medications that are not compatible with them personally. Maybe cycling could be introduced to people at a younger age as a assistance with treatment plans for maximizing success in ADHD management? Personally I feel like if I would have found cycling instead of skating when I was 13 or so, I would be in such a different place. like 5w/kg monster cyclist type place.

sorry to ramble

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Yeah, the medications are very individual, but the one thing that is consistent is that I have to be active, otherwise I go nuts.

When I was in high school and unmedicated, I was playing 20-25 hours of tennis per week on top of school and riding my bike to and from practice and didn’t even think any of it. Grades were good because I was getting enough stimulation. Every time that things have gone south since then has been a period of time where I wasn’t being active enough + being under-challenged in another area of my life.

~2 hours per day seems to be the sweet spot for physical activity for me, especially in the morning. If I can get that in, along with the medication, I’m super productive and happy.

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